Individual
URI SHABTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 E 14TH ST, SUITE 419, NEW YORK, NY 10003-4201
(212) 677-2000
(212) 353-5754
Mailing address
310 E 14TH ST, SUITE 419, NEW YORK, NY 10003-4201
(212) 677-2000
(212) 353-5754
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
171719
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01250375
—
NY
Enumeration date
07/01/2006
Last updated
04/23/2015
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